Pomegranate Wellness Health Aesthetics

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

POMEGRANATE WELLNESS HEALTH AESTHETICS

Practice address

203 Girard Rd N
Glassboro, NJ 08028-2117

Phone

(973) 731-6253

NPI assigned

Feb 2, 2019

Last updated

Feb 2, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pansy Harris-Lane, APNNPI 1063625135

Title

Owner

Phone

(973) 731-6253

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pansy Maureen Harris-Lane, NP

  • Adult Health Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1063625135
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549065600000",
    "number": "1912462029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 GIRARD RD N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282117",
            "telephone_number": "973-731-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 GIRARD RD N",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080282117",
            "telephone_number": "973-731-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMEGRANATE WELLNESS HEALTH AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-02",
        "last_updated": "2019-02-02",
        "status": "A",
        "authorized_official_last_name": "HARRIS-LANE",
        "authorized_official_first_name": "PANSY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-731-6253",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexander Jordan Pena, PT, DPT
• Melissa Pine
• Lauren Jessica Pino, PHARMD
• Danielle Player
• Helen E Polak, PSY.D.
• Nancy Marie Hurley Pontes, DNSC, RN, APN-C, BC
• Jill Powell
• Shipra Prasad, DNP, FNP-C
• Premier Orthopaedic & Sports Medicine Assoc of Southern NJ LLC
• Taylor Presbery-Fields

• Primary Care Clinic/Center in Glassboro, NJ
• Providers in Glassboro, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.